How is the procedure performed?
The procedure is performed under a combination of general and regional anaesthesia. An incision is made on the inner aspect of the elbow. The affected tendon is exposed and the damaged segment of tendon removed. The bone bed is treated with drilling, abrasion or microfracture.
Benefits
The main benefit of the procedure is to relieve pain, which in turn allows an improvement in the function of the elbow. More than 90% of patients achieve benefit from surgery.
Risks
Pain - The elbow may be painful for some days after surgery. This is usually managed by taking appropriate pain relieving medication and activity modification.
Swelling –The elbow may remain swollen and bruised for some days after surgery. You should keep the arm elevated after surgery for 5-7 days.
Bleeding – A small amount of bleeding is possible and will usually settle after a day or two.
Stiffness – This may occasionally occur after any form of elbow surgery. Prevention is the key and it is essential to follow the instructions provided, perform daily stretching and exercises at home to maintain the range of movements.
Infection – Infection is a possibility but rare.
Nerve injury – Injury to the nerves around the elbow is possible but rare. This may result in temporary numbness or weakness around the hand, wrist or forearm. Permanent nerve injuries are extremely rare.
Persistent symptoms – Some discomfort may persist despite the operation but is uncommon.
Aftercare
Following the procedure the surgical wound is closed with sutures and tapes and covered with a shower-proof dressing. The dressing should be left undisturbed as far as possible for 12-14 days. If the dressing is removed for any reason it should be replaced with a similar waterproof dressing. A compression bandage is applied after surgery and will usually be removed the following day. A sling will be provided to support the arm, but may be removed as tolerated to move the arm and is usually discarded after 2-3 days. A physiotherapist will provide instructions about mobilising the elbow prior to discharge from hospital. Outpatient physiotherapy may occasionally be recommended but is not always necessary. You may resume driving after 5-7 days. Strenuous tasks should be avoided for 6-8 weeks. Sports activities may gradually be resumed after 12 weeks.
Follow-up
An appointment will be arranged for you to be seen in the outpatient clinic two to four weeks after the procedure. Follow-up is required for at least 3-6 months after surgery or until a satisfactory recovery is achieved.